Tumor Necrosis Factor Alpha Levels As A Predictor Of Intussuception In Children: A Cross-Sectional Study

Authors

  • Nita Mariana
  • Ahmadwirawan
  • Jusli Aras
  • Ninny Meutia Pelupessy
  • Mochammad Hatta
  • Andi Matahari Rezkya Yusuf Putri

Keywords:

Intussusception, Emergency treatment, Laparotomy, Tumor Necrosis Factor-alpha

Abstract

Introduction: Intussusception (IS) is a medical emergency characterized by intestinal obstruction, which can be fatal if not promptly treated. In addition, several studies have identified infectious diseases, both viral and bacterial, as common predisposing factors for IS, often leading to elevated serum levels of Tumor Necrosis Factor alpha (TNF-α). Inflammatory mediators, such as TNF-α can significantly influence gastrointestinal motility, and the resulting alterations may contribute to the development of intussusception. Hence, this study determines the relationship between TNF-α levels and intussusception in children.

Methods: This cross-sectional study was performed applying simple random sampling, which examined ELISA results on the blood of intussusception patients before exploratory laparotomy milking, resection, or enterostomy at an institution from January to December 2023.

Results: The sample population was 10 patients (6 males and 4 females) who underwent exploratory laparotomy milking (3) and resection/enterostomy (7). Based on the results, the TNF-α mean level was higher at 357.4032 in patients who underwent resection than 83.6314 in those who did not undergo the procedure. In addition, TNF-α levels in patients with resection/enterostomy were higher compared to those without resection with a p-value of < α (0.000 < 0.05).

Conclusion: The findings showed a significant association on TNF-α levels and the incidence of intussusception. TNF-α levels in intussusception patients who underwent resection/enterostomy were higher compared to those without resection. However, further studies using larger sample sizes were still needed to assess the relationship between TNF-α levels and other diseases, with healthy children as controls.

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References

Hassan A, Zain M, Ghazaly Y. Primary neonatal ileoileal intussusception. J Pediatr Surg Case Rep. 2019;41:18-20. doi:10.1016/j.epsc.2018.11.003

Kotloff KL. Abdominal Symptom Complexes. In: Principles and Practice of Pediatric Infectious Diseases. Elsevier; 2023:178-182.e1. doi:10.1016/B978-0-323-75608-2.00022-7

Burnett E, Kabir F, Van Trang N, et al. Infectious Etiologies of Intussusception Among Children <2 Years Old in 4 Asian Countries. J Infect Dis. 2020;221(9):1499-1505. doi:10.1093/infdis/jiz621

Bessey TK, Parashar UD, Tate JE, Madhi SA, Jiang B, Groome MJ. Cytokine profiles in children with acute intussusception in South Africa. Cytokine. 2021;146:155639. doi:10.1016/j.cyto.2021.155639

Ruder B, Atreya R, Becker C. Tumour Necrosis Factor Alpha in Intestinal Homeostasis and Gut Related Diseases. Int J Mol Sci. 2019;20(8). doi:10.3390/ijms20081887

Amelia Gosal A, Aizah Lawang S, Jaya Ganda I, Angriani H, Dewi Artati R. Positive Fluid Balance as a Prognosis Predictor in Pediatric Sepsis Patients: A Retrospective Cohort Study. Nusantara Medical Science Journa. 2023;8(1):1-9. doi:https://doi.org/10.20956/nmsj.v8i1.23615

Docsa T, Sipos A, Cox CS, Uray K. The Role of Inflammatory Mediators in the Development of Gastrointestinal Motility Disorders. Int J Mol Sci. 2022;23(13):6917. doi:10.3390/ijms23136917

Sönmez K, Karabulut R, Türkyılmaz Z, et al. Association of Tumor Necrosis Factor, Interleukin-6 and Cyclooxygenase Pathway with Lipopolysaccharide-Induced Intussusception. European Journal of Pediatric Surgery. 2008;18(2):103-106. doi:10.1055/s-2007-989375

Li Y, Li Y, Liu W, Wang B, Wang P, Qi Y. Th2/Th1 cytokine imbalance is associated with higher recurrent intussusception incidence in children: A 10-year retrospective study of 1657 patients. Medicine. 2023;102(13):e33391. doi:10.1097/MD.0000000000033391

Marsicovetere P, Ivatury SJ, White B, Holubar SD. Intestinal Intussusception: Etiology, Diagnosis, and Treatment. Clin Colon Rectal Surg. 2017;30(1):30-39. doi:10.1055/s-0036-1593429

Blair SG, Quang CY, Simmons JD, Grimm Jr LM, Rider PF, Richards WO. Intussusception in Patients with Crohn’s Disease: Is Resection Always Mandated? Clin Surg. 2017;2:1-2.

Potts J, Al Samaraee A, El-Hakeem A. Small bowel intussusception in adults. Ann R Coll Surg Engl. 2014;96(1):11-14. doi:10.1308/003588414X13824511650579

Minney-Smith CA, Levy A, Hodge M, et al. Intussusception is associated with the detection of adenovirus C, enterovirus B and rotavirus in a rotavirus vaccinated population. Journal of Clinical Virology. 2014;61(4):579-584. doi:10.1016/j.jcv.2014.10.018

Silva LB, dos Santos Neto AP, Maia SMAS, et al. The Role of TNF-α as a Proinflammatory Cytokine in Pathological Processes. Open Dent J. 2019;13(1):332-338. doi:10.2174/1874210601913010332

Ma TY, Iwamoto GK, Hoa NT, et al. TNF-alpha-induced increase in intestinal epithelial tight junction permeability requires NF-kappa B activation. Am J Physiol Gastrointest Liver Physiol. 2004;286(3):G367-76. doi:10.1152/ajpgi.00173.2003

Badriyyah M, Mazeh H, Brocke S, Osmanova V, Freund HR, Hanani M. Prevention of lipopolysaccharide-induced intussusception in mice by the COX2 inhibitor rofecoxib. Pediatr Surg Int. 2008;24(3):333-336. doi:10.1007/s00383-007-2066-8

Burchard PR, Thomay AA. Appendiceal intussusception in the setting of ulcerative colitis. J Surg Case Rep. 2018;2018(4):rjy044. doi:10.1093/jscr/rjy044

Jang D in, Lee AH, Shin HY, et al. The Role of Tumor Necrosis Factor Alpha (TNF-α) in Autoimmune Disease and Current TNF-α Inhibitors in Therapeutics. Int J Mol Sci. 2021;22(5):2719. doi:10.3390/ijms22052719

Vanamee ÉS, Faustman DL. Structural principles of tumor necrosis factor superfamily signaling. Sci Signal. 2018;11(511). doi:10.1126/scisignal.aao4910

BARBARA JA, VAN OSTADE X, LOPEZ AF. Tumour necrosis factor‐alpha (TNF‐α): The good, the bad and potentially very effective. Immunol Cell Biol. 1996;74(5):434-443. doi:10.1038/icb.1996.73

Puimège L, Libert C, Van Hauwermeiren F. Regulation and dysregulation of tumor necrosis factor receptor-1. Cytokine Growth Factor Rev. 2014;25(3):285-300. doi:10.1016/j.cytogfr.2014.03.004

Micheau O, Tschopp J. Induction of TNF Receptor I-Mediated Apoptosis via Two Sequential Signaling Complexes. Cell. 2003;114(2):181-190. doi:10.1016/S0092-8674(03)00521-X

Günther C, Neumann H, Neurath MF, Becker C. Apoptosis, necrosis and necroptosis: cell death regulation in the intestinal epithelium. Gut. 2013;62(7):1062-1071. doi:10.1136/gutjnl-2011-301364

Mariana N, Asadul Isl A, Hatta M, Fransiscus H. IL23 mRNA Expression in Hirschsprung-Associated Enterocolitis. Journal of Medical Sciences. 2020;20(2):39-43. doi:10.3923/jms.2020.39.43

Tabuchi T, Shimazaki J, Satani T, Nakachi T, Watanabe Y, Tabuchi T. The perioperative granulocyte/lymphocyte ratio is a clinically relevant marker of surgical stress in patients with colorectal cancer. Cytokine. 2011;53(2):243-248. doi:10.1016/j.cyto.2010.10.004

Nissan A, Zhang JM, Lin Z, Haskel Y, Freund HR, Hanani M. The contribution of inflammatory mediators and nitric oxide to lipopolysaccharide-induced intussusception in mice. J Surg Res. 1997;69(1):205-207. doi:10.1006/jsre.1997.5078

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Published

2025-06-13

How to Cite

1.
Mariana N, Ahmadwirawan A, Aras J, Pelupessy NM, Hatta M, Yusuf Putri AMR. Tumor Necrosis Factor Alpha Levels As A Predictor Of Intussuception In Children: A Cross-Sectional Study. J Neonatal Surg [Internet]. 2025Jun.13 [cited 2025Sep.18];14(31S):875-82. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/7320

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